Healthcare Provider Details

I. General information

NPI: 1144140419
Provider Name (Legal Business Name): LISA G PARISI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MAGNOLIA LN
SMITHTOWN NY
11787-3735
US

IV. Provider business mailing address

10 MAGNOLIA LN
SMITHTOWN NY
11787-3735
US

V. Phone/Fax

Practice location:
  • Phone: 516-639-9104
  • Fax:
Mailing address:
  • Phone: 516-639-9104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number6073335
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: